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Mining clinical text for stroke prediction

  • Elham Sedghi
  • Jens H. Weber
  • Alex Thomo
  • Maximilian Bibok
  • Andrew M. W. Penn
Original Article
  • 196 Downloads

Abstract

One of the main problems in treating stroke patients is accurate and timely triage and assessment. Not all stroke events have direct severe consequences. Full strokes are often preceded by transient ischemic attacks (TIA) or mini strokes, which exhibit signs and symptoms similar to less concerning health events, e.g., migraines. In this paper, natural language techniques are presented to process a large collection of medical narrative descriptions extracting features that can be subsequently used for automatic classification using Data Mining algorithms. We reviewed 5658 cases and analyzed the chief complaint and history of the patient illness reported at stroke rapid assessment unit (SRAU) at Victoria General Hospital (VGH). Data were collected by neurologists and stroke nurses between years 2008 and 2013. Based on a clinician-supplied list of important sign and symptom terms, we translated narrative medical text into well-codified sentences achieving an impressive agreement with a human expert. Afterwards, Data Mining algorithms were applied on codified data and obtaining not only prediction models, but also important weights for the codified terms. An extensive experimental evaluation of several classifiers is provided based on past data to predict new cases. Notably, we achieved a sensitivity of about 84 % and specificity of 64 % using support vector machines (SVM). The top terms identified by data mining algorithms were responsible for most of the prediction quality; therefore, they can be used to build a questionnaire-like, online application that can be employed as a first-line screening in triage for detecting stroke/TIA or mimic and help triage decide for the next step of treatment or discharge the patient.

Keywords

Support Vector Machine Receiver Operating Characteristic Curve Natural Language Processing Negative Word Data Mining Algorithm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors would like to acknowledge Kristine Votova, Ph.D., the project manager for the SpecTRA Research Project and the Island Health clinical research team at the Stroke Rapid Assessment Unit for their support. Funding for the natural experiment in stroke care and the large-scale personalized medicine for mass spectrometry in rapid TIA triage comes from Canadian Institute of Health Research (2009–2012) and Genome Canada/BC (2013–2017).

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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Elham Sedghi
    • 1
  • Jens H. Weber
    • 1
  • Alex Thomo
    • 1
  • Maximilian Bibok
    • 2
  • Andrew M. W. Penn
    • 2
  1. 1.Department of Computer ScienceUniversity of VictoriaVictoriaCanada
  2. 2.SpecTRA Research Project, Vancouver Island Health AuthorityVictoriaCanada

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